Two months ago, the Fridge Militia (as I like to call them) was interested in getting some sense of the state of immunization vaccine refrigerators. How many practices actually use medical quality equipment? How common are generators? How many doctors actually have two-way communication with their valuable resources? The improvement of vaccine storage is an overlooked, yet incredibly important, aspect of pediatric healthcare delivery and I applaud the effort of the AAP, Dr. Barden, and Dr. Warner.

To the survey. We received nearly 100 responses from practices of all sizes, spread out among practices around the country.

Of the fridges we accounted for, 60% of them are medical grade and 40% of them are commercial/domestic. For practices who have >1 fridge, many of them are "mixed" - that is, they have at least one of each level of equipment. I can't say this scientifically, but I suspect that many practices are replacing their older fridges as they break down with new, medical grade units but keeping the ones that still work. To my surprise, 10% of the practices had stand alone freezers as well, but we didn't ask details about that equipment.

Of the medical grade fridges, 90% have a digital thermometer.

Among all the fridges, 75% have at least one digital Mon/Max thermometer. 65% additionally include data logging (yay!).

I was surprised to see that 55% of the fridges have some level of communication monitor in the event of a temperature or power problem. Of course, two way communication is a vital part of this strategy (so you keep getting alerts until they are acknowledged), and it appears that most people have this functionality.

We wanted to get some sense of whether the size of the practice and/or the volume of stored vaccines has any effect on these numbers. Do larger practices have a better vaccine storage program? The answer appears to be...that there's no correlation. We looked at the size of private vaccine inventory - from $5K to $250K (average: $60K, median: $50K) - we didn't see any measurable difference in use of medical grade equipment.

We also looked at VFC distribution (with inventories ranging from $0 to $500K(!), but a median of $20K) and it had no effect either.

When we asked the question, "Would it speed your adaptation of better refrigerators if the documentation for VFC inspections were considerably easier for the electronic medical grade refrigerators?" the answer was...yes. It would help a lot. No surprise there. This is a good sign for the vendors pushing into the new automated storage arena.

We learned that the overwhelming number of respondents work with some kind of GPO to purchase private vaccines...but there are some who do not! Please join a GPO, any GPO! Especially when 20% of them have negotiated better pricing on medical fridges.

What do we take from all this? I don't have data from, say, 10 years ago but my gut tells me that the use of medical grade vaccine storage is on the rise. I know, from visiting too many offices to count, that medical grade fridges were a small sliver of the equipment installed. Today, they are the majority.